[Chris Lassiter]

Great question! The RECEPETIONIST AND PHONE SKILLS COURSE has a lesson called “Answering Dental PPO Questions” – That discusses how to handle questions from patients. My best advice is to have a consistent message when handling insurance conversations – “We do everything we can to maximize your benefits. We are considered out of network with your insurance which means we can absolutely treat you in our office; the difference will be that you will pay when you are here, we will submit the insurance claim for you and the insurance company will reimburse you directly.” There are a lot of different ways to get this message across; As long as the entire team is consistent and confident in the delivery it should be a fairly simple conversation. If you have nay other questions or want to discuss this further feel free to email me at [email protected]! Have a great day!

[Chris Lassiter]

Heather – Thank you for posting your question! Colleen has reviewed it and is working on a response. She is currently traveling and will provide more information as soon as possible!

[Chris Lassiter]

From Colleen Huff:

“….You do need to keep a copy of the EOB as it is part of the patient’s chart. Now if you are getting an ERA downloaded into your account then you do not need the EOB also as they are the same.”

[Chris Lassiter]

CONGRATULATIONS on taking the steps to go out of network! I don’t think it needs to be complicated. Be up front with patients about why you are making this change and explain what this looks like for them moving forward. If you are concerned about patients not accepting treatment because of the cost, you can provide financial relief options like CareCredit, or you can split their payments – half at scheduling and the remainder on the day of treatment. When patients understand the reasoning behind a change like this, they will be fine. You want to be able to provide an exceptional standard of care and you cannot do that as an in network provider. So, they will be getting the care they need and utilizing the benefits they pay for; The only change is they will pay at the time of service and then be reimbursed directly. Make sure your team has the proper verbiage for explaining the process. I hope this helps! If you want to discuss this further, feel free to send me an email to [email protected] and we can continue the conversation.

[Chris Lassiter]

Thank you, Colleen. For anyone who wants more information, Colleen posted an update on the Front Office Rocks Facebook page last night, along with some useful links. She will be helping keep us up to date on the situation as it unfolds. Good luck to everyone as you navigate this somewhat confusing scenario.

• This reply was modified 1 year, 2 months ago by  Chris Lassiter.

[Chris Lassiter]

• Colleen- Dental Insurance Coach Huff

  Moderator

  January 24, 2024 at 7:26 pm

  So the first question is which state are you in? There are some states that allow you to use both but you would bill to the insurance company the discounted rate. The patient would pay the lowest Fee schedule. IF they sign an exempt form- the work that is done can NEVER be shared with anyone else. So all work regarding that/those teeth cannot leave the office or be given out with their history. This is a very difficult thing to track and could lead to a potential HIPAA breach at some point in the future. Also that patient can retract that release at any time and you would then be billing the insurance and could end up owing that patient money back.

  I hope that makes sense or helps.

staging.frontofficerocks.com

Discussions – Office Managers & Business Administrators – Front Office Rocks

Discussions – Office Managers & Business Administrators – Front Office Rocks

[Chris Lassiter]

Thank you for your question. I am going to pass this question along to Colleen Huff, dental insurance coach and expert, for an answer. I will post this in the PATIENT INSURANCE AND FINANCIALS community as well. As soon as I have a response, I will make sure to post it here. THANK YOU!

[Chris Lassiter]

** I also wanted to share this weekly bonus plan resource….I hope this helps!

[Chris Lassiter]

Great discussion topic! I have attached an article that will be helpful as you work towards what your particular plan will look like. Good luck!

[Chris Lassiter]

As with anything like this, we recommend double checking with your state guidelines to be sure you are in compliance. GOOD LUCK!

[Chris Lassiter]

Thanks for the question.

When speaking to patients about dental insurance, it’s important to establish a positive and welcoming tone from the beginning of the conversation. You can start the call by acknowledging their interest in dental care and expressing your enthusiasm to assist them. Building rapport and understanding their needs should be your initial focus, allowing you to gather more information about why they are calling.

Once you have established a connection, you can then address their questions about insurance. By approaching it this way, you create an opportunity to explain how insurance works for your practice in a clear and concise manner. This approach ensures that the patient feels valued and understood, while also providing them with the necessary information about insurance coverage. Remember, the goal is to balance the importance of addressing insurance inquiries while also building a strong rapport with the patient.

[Chris Lassiter]

Thank you for your question. If a patient calls with an emergency, we always explain that we will do what we can to get them out of pain. We also let them know that we are fitting them in and a second appointment may be needed to complete any treatment. This allows you to determine if this is a “true emergency” and it also allows you to manage the patient’s expectation of their visit. I would highly recommend letting them know what to expect during the appointment – PA, limited exam – and the cost. You may ask them if they have insurance and explain that you will do your best to verify their benefits prior to their visit, but they will be responsible for the cost of the visit. Again, this lets you know if this is a true emergency. Letting patients know in advance what they can expect as far as treatment anf financial obligations is important so there are no suprises.

When the patient arrives, explain to them again what the appointment will entail. If you were not able to get the insurance information verified, collect the amount that will be due prior to taking them to the operatory. If further treatment is needed, you can present a treatment plan and discuss finances before moving forward.

I hope this helps!

Missy

[Chris Lassiter]

I think that would make the most sense, yes.

[Chris Lassiter]

Of course. If there is anything else we can help with, let us know!

Missy –Practice Management Expert and Coach

[Chris Lassiter]

Thanks for bringing to our attention. My initial thought when I read this was there are MANY times we feel like swearing though don’t we. ?.

• This reply was modified 1 year, 7 months ago by  Chris Lassiter.